Opening Pathways to Practice for Internationally Trained Physicians

This brief report reviews examples of policy options that states are employing to assist international medical graduates (IMGs) who face significant challenges in re-entering the health care workforce in the United States.  These challenges often include having to repeat years of post-graduate clinical training (residency) and limited access to residency training positions. In order to facilitate physician licensure, states have pursued strategies such as state-funded residencies and residency preparation programs, faculty licensing, exceptional qualification waivers, and restricted physician licensure.  The report gives examples from the following states:  1) Minnesota (“expanding the number of residency slots available to IMGs” and developing an IMG Assistance Program); 2) Arkansas and Virginia (“IMGs are permitted to practice clinically in a medical school setting for a limited term under an ‘academic,’ ‘professorial,’ or ‘fellow’ license, thus satisfying clinical experience requirements and eliminating the need for a U.S. residency for IMGs seeking full licensure”); 3) Washington (“waiving residency training requirements“ for IMGs with ‘exceptional ability,’ including ‘extensive work related to ‘research, medical excellence, or employment’”); 4) West Virginia, Washington, and Minnesota (“creating a category of ‘restricted’ or ‘limited’ physician licensure that allows IMGs with exceptional professional credentials to practice under limitations or conditions defined by the state’s Board of Medicine”); and 5) Missouri (“issuing licenses for assistant or associate physicians” who meet appropriate criteria to “practice in underserved areas under a supervising physician”). Additionally, state-funded clinical readiness programs for IMGs have been funded in California, Minnesota, and Washington; and inter-governmental and cross-sector work groups or commissions have been created to explore ways to reduce barriers to licensure in Massachusetts, Virginia, and Washington. (Robert Like, MD, MS)

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